- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $25.70 / $144.54
| Facility | | $8.91 | $25.70 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $33.11
| Professional | | $6.03 | $7.94 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.59 / $100.00
| Facility | | $8.13 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $8.91 / $21.88
| Professional | | $5.25 | $8.91 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $31.62
| Facility | | $17.78 | $22.39 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $11.22
| Professional | | $8.32 | $8.32 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $14.13 / $34.67
| Facility | | $6.92 | $14.13 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.23 / $23.44
| Professional | | $5.37 | $10.23 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $69.18 / $7,079.46
| Facility | | $10.00 | $69.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $15.49
| Professional | | $13.18 | $13.18 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $24.55
| Professional | | $8.91 | $8.91 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $22.39 / $39.81
| Facility | | $9.33 | $22.39 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.59 / $100.00
| Facility | | $8.13 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $8.91 / $21.88
| Professional | | $5.25 | $8.91 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.91 / $13.18
| Facility | | $4.47 | $8.91 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.24 / $23.99
| Professional | | $5.25 | $7.24 | $23.99 |